CAJ | 학술논문

目的建立并验证Kasabach-Merritt现象裸鼠移植模型,为血管瘤的基础与临床研究提供有效的载体.方法收集对数生长期的鼠源性血管瘤内皮细胞系(EOMA),裸鼠皮下注射,观察并记录肿瘤的生长情况,外周血行血常规检查,对肿瘤局部行B型超声、彩色多普勒血流显像(color doppler flow imaging,CDFI)扫查,骨髓涂片,行光镜观察,局部肿瘤及各脏器病理切片检查.结果实验组成瘤率达100％,而对照组无一成瘤;随着肿瘤的不断增长,实验组裸鼠外周血红细胞计数(RBC)、血红蛋白量(Hb)、血细胞比容(Hct)、血小板计数(PLT)迅速下降(与接种前比较P＜0.01);骨髓像显示:实验组产板型巨核细胞(1.75±1.28)个与对照组(3.63±1.06)个比较,显著减少,差异有统计学意义(P＜0.01);超声检查发现肿瘤均仅限于皮下;彩色多普勒血流显像(color doppler flow imaging,CDFI)显示瘤体内以静脉血流为主;病理学检查诊断为血管内皮瘤,各脏器病理切片检查均未发现有转移瘤;成瘤组与对照组相比,成瘤组脾重(0.55±0.16)g与对照组(0.11±0.02)g比较差异显著(P＜0.01).结论 ①成功构建了Kasabach-Merritt现象裸鼠模型.该模型操作简单、成瘤率高、成瘤周期短,是血管瘤基础和临床研究的良好载体;②Kasabach-Merritt现象血小板减少有3方面机制:骨髓中产板型巨核细胞减少,其来源受限;脾脏功能亢进,脾内破坏增加;血管瘤瘤内破坏增多.
목적 건립병험증Kasabach-Merritt현상라서이식모형,위혈관류적기출여림상연구제공유효적재체.방법 수집대수생장기적서원성혈관류내피세포계(EOMA),라서피하주사,관찰병기록종류적생장정황,외주혈행혈상규검사,대종류국부행B형초성、채색다보륵혈류현상(color doppler flow imaging,CDFI)소사,골수도편,행광경관찰,국부종류급각장기병리절편검사.결과 실험조성류솔체100％,이대조조무일성류;수착종류적불단증장,실험조라서외주혈홍세포계수(RBC)、혈홍단백량(Hb)、혈세포비용(Hct)、혈소판계수(PLT)신속하강(여접충전비교P＜0.01);골수상현시:실험조산판형거핵세포(1.75±1.28)개여대조조(3.63±1.06)개비교,현저감소,차이유통계학의의(P＜0.01);초성검사발현종류균부한우피하;채색다보륵혈류현상(color doppler flow imaging,CDFI)현시류체내이정맥혈류위주;병이학검사진단위혈관내피류,각장기병리절편검사균미발현유전이류;성류조여대조조상비,성류조비중(0.55±0.16)g여대조조(0.11±0.02)g비교차이현저(P＜0.01).결론 ①성공구건료Kasabach-Merritt현상라서모형.해모형조작간단、성류솔고、성류주기단,시혈관류기출화림상연구적량호재체;②Kasabach-Merritt현상혈소판감소유3방면궤제:골수중산판형거핵세포감소,기래원수한;비장공능항진,비내파배증가;혈관류류내파배증다.
Objective To establish and verify Kasabach-Merritt syndrome model with nude mice and provide effective support for basic and clinical research on hemangioma.Methods During logarithmic growth phase,murine hemangioendothelioma cells (EOMA) were collected and implanted subcutaneously into nude mice.Tumor growth was observed and recorded,peripheral blood tested,tumor scanned with B ultrasound and color doppler flow imaging (CDFI),light microscopic examination after bone marrow smearing,local tumor and organ biopsy performed.Results The tumor formation rate of experimental group was 100％ while there was no tumor formation for control group.With tumors growing,red blood cell count,hemoglobin concentration,hematocrit and platelets counts declined sharply (versus pre-vaccination,P ＜ 0.01) ; marrow image:plate megakaryocyte count significantly decreased versus control group (P＜0.01) ; ultrasound examination revealed tumor was confined to skin; CDFI indicated that tumor had venous blood; pathological diagnosis was vascular endothelial tumor.And metastasis was absent.The spleen of tumor group significantly increased versus control group (P＜0.01).Conclusions The nude mice model of Kasabach-Merritt syndrome has been successfully constructed.It is simple to handle with a high rate of tumor formation and a short cycle of tumor formation so as to be an ideal carrier for basic and clinical studies of hemangioma.Three mechanisms on thrombocytopenia for Kasabach-Merritt syndrome:a lowered production of bone marrow megakaryocyte plate due to its limited source,spleen hyperthyroidism and extensive destruction in spleen and hemangioma.